Managing a Young Adolescent with Bipolar Disorder: An Experience from Nepal - Abstract
Bipolar disorder (BD) is a common psychiatric problem in youths and can pose a challenge in diagnosis in children and adolescents. The diagnosis of Youth Bipolar Disorders is complicated due to the various overlapping symptoms shared by other psychiatric disorders like attention deficit hyperactivity disorder (ADHD). Varying presentation, having ill defined diagnostic criteria and increased comorbidity are the
major challenges faced for the assessment of the BD in early teens. We report a case of a 13 year old boy, who presented with decreased sleep, over talkativeness, distractibility, hyperactivity in the form of increased dancing and singing, irritable mood and inflated self-esteem in the absence of positive family history. He was diagnosed as BD by using DSM-5 criteria and after repeated mental state examinations, rating scale, exploring history from parents, family members and teachers. Though diagnosis might not be difficult in an American setup, it is difficult here because of the educational and cultural background. There was significant improvement in his illness following two weeks of treatment with olanzapine, lithium and behavioural techniques but the maintenance of remission is quiet challenging in the socio-economic scenario of Nepal.